Increase In Subcutaneous Adipose Tissue Research Articles

Change in abdominal obesity after colon cancer surgery – effects of left-sided and right-sided colonic resection

BackgroundExcess abdominal visceral adipose tissue (VAT) is associated with metabolic diseases and poor survival in colon cancer (CC). We assessed the impact of different types of CC surgery on changes in abdominal fat depots.Material and methodsComputed tomography (CT)-scans performed preoperative and 3 years after CC surgery were analyzed at L3-level for VAT, subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) areas. We assessed changes in VAT, SAT, TAT and VAT/SAT ratio after 3 years and compared the changes between patients who had undergone left-sided and right-sided colonic resection in the total population and in men and women separately.ResultsA total of 134 patients with stage I-III CC undergoing cancer surgery were included. Patients who had undergone left-sided colonic resection had after 3 years follow-up a 5% (95% CI: 2–9%, p < 0.01) increase in abdominal VAT, a 4% (95% CI: 2–6%, p < 0.001) increase in SAT and a 5% increase (95% CI: 2–7%, p < 0.01) in TAT. Patients who had undergone right-sided colonic resection had no change in VAT, but a 6% (95% CI: 4–9%, p < 0.001) increase in SAT and a 4% (95% CI: 1–7%, p < 0.01) increase in TAT after 3 years. Stratified by sex, only males undergoing left-sided colonic resection had a significant VAT increase of 6% (95% CI: 2–10%, p < 0.01) after 3 years.ConclusionAfter 3 years follow-up survivors of CC accumulated abdominal adipose tissue. Notably, those who underwent left-sided colonic resection had increased VAT and SAT, whereas those who underwent right-sided colonic resection demonstrated solely increased SAT.

Increase in subcutaneous adipose tissue in the frontal scalp may be associated with androgenetic alopecia and metabolic syndrome.

Recent studies have suggested that androgenetic alopecia (AGA) may be associated with other disorders, especially metabolic syndrome (MetS). This study aimed to determine whether a connection exists between MetS and AGA based on the thickness of the subcutaneous adipose tissue in the scalp. This cross-sectional study included 34 participants with AGA who had MetS and 33 participants with AGA who did not have MetS. The Hamilton-Norwood scale was employed for classifying AGA and MetS was identified using the US National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III criteria). The body mass index (BMI), blood pressure, and lipid profiles of the participants were assessed. Hepatosteatosis and the thickness of the subcutaneous adipose tissue in the scalp were examined using ultrasonography. Compared with the control group, the MetS+AGA group had higher BMI (p = 0.011), systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and waist circumference (p = 0.003). Furthermore, the MetS+AGA group had a higher prevalence of dyslipidemia, hypertension (HT) and diabetes mellitus (DM) and higher rates of grade 6 alopecia than the control group (p = 0.019). Compared with the control group, those with MetS had thicker subcutaneous adipose tissue in the frontal scalp (p = 0.018). The subcutaneous adipose tissue in the frontal scalp was thicker in individuals with AGA who had high Hamilton scores. The concomitance of AGA and MetS may be associated with a high increase in subcutaneous adipose tissue and less favorable metabolic parameters.

Body Composition in Patients with Follicular Lymphoma: Asso-Ciations between Changes in Radiomic Parameters in Patients Treated with R-CHOP-like and R-B Regimens: LyRa 01F

In patients with follicular lymphoma (FL), therapeutic advances have led to improved survival, and within this framework, it is important to identify treatment strategies offering a better quality of life. Using (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT), in patients treated with R-CHOP-like or R-Bendamustine regimens, we assessed changes in the bone mineral density (BMD), musculoskeletal index (SMI), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) at disease onset and at the end of therapy. We evaluated whether the high-steroid regimen could lead to more significant radiological changes than those induced by the steroid-free regimen and whether a low BMD at disease onset is an unfavorable prognostic index. Seventy-nine patients between 60 and 80 years old with a new diagnosis of FL were included in the study. Evaluation of Delta values (pre- and post-therapy mean values) in the two immunochemotherapy regimens showed differences in radiomic parameters within the two patient cohorts. The R-CHOP-like regimen was associated with a significant reduction in BMD, an increase in SAT and VAT, and a reduction in skeletal muscle density (SMD) and SMI. Moreover, patients with high FLIPI showed a BMD below the cut-off value. This study represents the first study demonstrating a prognostic correlation between FLIPI and low BMD.

Effect of a ketogenic diet on pain and quality of life in patients with lipedema: The LIPODIET pilot study

BackgroundLipedema is an underdiagnosed condition in women, characterized by a symmetrical increase in subcutaneous adipose tissue (SAT) in the lower extremities, sparing the trunk. The lipedema SAT has been found to be resistant to diet, exercise and bariatric surgery, in regard to both weight loss (WL) and symptom relief. Current experience indicates that a low carbohydrate and high fat (LCHF‐diet) might have a beneficial effect on weight and symptom management in lipedema.ObjectiveTo assess the impact of an eucaloric low carbohydrate, high fat (LCHF)‐diet on pain and quality of life (QoL) in patients with lipedema.MethodsWomen diagnosed with lipedema, including all types and stages affecting the legs, (age 18–75 years, BMI 30–45 kg/m2) underwent 7 weeks of LCHF‐diet and, thereafter 6 weeks of a diet following the Nordic nutrition recommendations. Pain (visual analog scale) and QoL (questionnaire for lymphedema of the limbs), weight and body composition were measured at baseline, week seven and 13.ResultsNine women (BMI: 36.7 ± 4.5 kg/m2 and age: 46.9 ± 7 years) were recruited. The LCHF diet induced a significant WL −4.6 ± 0.7 kg (−4.5 ± 2.4%), p < 0.001 for both, and reduction in pain (−2.3 ± 0.4 cm, p = 0.020). No correlation was found between WL and changes in pain at week seven (r = 0.283, p = 0.460). WL was maintained between week seven and 13 (0.3 ± 0.7 kg, p = 0.430), but pain returned to baseline levels at week 13 (4.2 ± 0.7 cm, p = 0.690). A significant increase in general QoL was found between baseline and week seven (1.0 (95% CI (2.0, 0.001)), p = 0.050) and 13 (1.0 95% CI (2.0, 0.001) p = 0.050), respectively.ConclusionA LCHF‐diet is associated with reduction in perceived pain and improvement in QoL, in patients with lipedema. Larger randomized clinical trials are needed to confirm these findings.

Liver Fat, Adipose Tissue, and Body Composition Changes After Switching from a Protease Inhibitor or Efavirenz to Raltegravir.

Integrase inhibitors appear to increase body weight, but paradoxically some data indicate that raltegravir (RAL) may decrease liver fat. Our objective was to study the effects of switching from a protease inhibitor (PI) or efavirenz (EFV) to RAL on liver fat, body composition, and metabolic parameters among people living with HIV (PLWH) with high risk for nonalcoholic fatty liver disease (NAFLD). We randomized overweight PLWH with signs of metabolic syndrome to switch a PI or EFV to RAL (n = 19) or to continue unchanged antiretroviral therapy (control, n = 24) for 24 weeks. Liver fat was measured by magnetic resonance spectroscopy (MRS), body composition by magnetic resonance imaging, and bioimpedance analysis; subcutaneous fat biopsies were obtained. Median (interquartile range) liver fat content was normal in RAL 2.3% (1.1-6.0) and control 3.1% (1.6-7.3) group at baseline. Liver fat and visceral adipose tissue remained unchanged during the study. Body weight [from 85.9 kg (76.1-97.7) to 89.3 (78.7-98.7), p = 0.019], body fat mass [from 20.3 kg (14.6-29.7) to 22.7 (17.0-29.7), p = 0.015], and subcutaneous adipose tissue (SAT) volume [from 3979 mL (2068-6468) to 4043 (2206-6433), p = 0.048] increased, yet, adipocyte size [from 564 pL (437-733) to 478 (423-587), p = 0.019] decreased in RAL but remained unchanged in control group. Circulating lipids and inflammatory markers improved in RAL compared to control group. The median liver fat measured by MRS was unexpectedly within normal range in this relatively small study population with presumably high risk for NAFLD contradicting high prevalence of NAFLD reported with other methods. Despite weight gain, increase in SAT together with decreased adipocyte size and reduced inflammation may reflect improved adipose tissue function. Clinical Trial Registration number: NCT03374358.

The Effect of TNF and Non-TNF-Targeted Biologics on Body Composition in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is associated with a decrease in lean mass and stability or even an increase in fat and ectopic adipose tissue. A few data are available on body composition changes under treatment, and data are still controversial. Body composition was assessed before initiation of biologic disease-modifying antirheumatic drug (bDMARD) and after 6 and 12 months of stable treatment. Eighty-three RA patients were included (75% of women, mean age 58.5 ± 10.8 years) of whom 47 patients treated with TNF inhibitor (TNFi), 18 with non-TNF-targeted biologic (Non-TNFi), and 18 with conventional DMARD (cDMARD) alone. In the TNFi group, total lean mass, fat-free mass index, and skeletal muscle mass index significantly increased at 1 year. An increase in subcutaneous adipose tissue (SAT) without change for the visceral or body fat composition was associated. These changes were associated with an improvement in strength and walking test. In non-TNFi or cDMARD groups, no significant changes for body composition or muscle function were observed at 1 year. However, no significant differences for treatment x time interaction were noted between group treatments. In active RA patients starting first bDMARD, treatment with TNFi over 1 year was associated with favorable changes of the body composition and muscle function.

Nutrient Patterns and Body Composition Parameters of Black South African Women.

Obesity is more prevalent in black South African women than men. However, little is known about the nutrient patterns associated with body composition indices in black African women. Principle Component Analysis (PCA) was applied to 25 nutrients derived from quantified food frequency questionnaires (QFFQs) in 498 middle aged black South African women. Three nutrient patterns, the plant driven, animal driven and Vitamin C, sugar and potassium driven nutrient patterns, accounted for 59% of the variance of nutrient intake. Linear models of the body composition parameters as outcome variables indicated that a standard deviation increase in the animal driven nutrient pattern was significantly associated with increases in body mass index (BMI) (1.29 kg·m−2 (95% CI, 0.54–2.04; p = 0.001), subcutaneous adipose tissue (SAT) (26.30 cm2 (7.97–44.63); p = 0.005), visceral adipose tissue (VAT) (9.88 cm2 (5.13–14.63); p < 0.001), VAT/SAT ratio (0.01 (0.00–0.02); p = 0.018), whole body fat mass index (0.74 kg·m−2 (0.25–1.22); p = 0.003), and whole body lean mass index (0.53 kg·m−2 (0.23–0.83); p = 0.001). An increase in plant driven nutrient pattern was significantly associated with an increase in SAT of 20.45 cm2 (0.47–40.43); p = 0.045. This study demonstrates that animal driven nutrient pattern, characterised by the consumption of more animal protein and fat nutrients, similar to the western diet is associated with increased body fat and lean mass.

Do current guidelines for waist circumference apply to black Africans? Prediction of insulin resistance by waist circumference among Africans living in America

BackgroundTo lower the risk of diabetes and heart disease in Africa, identification of African-centred thresholds for inexpensive biomarkers of insulin resistance (IR) is essential. The waist circumference (WC) thresholds that...

Intermittent hypoxia-induced insulin resistance is associated with alterations in white fat distribution

Sleep apnea syndrome is characterized by repetitive upper airway collapses during night leading to intermittent hypoxia (IH). The latter is responsible for metabolic disturbances that rely, at least in part, on abdominal white fat inflammation. Besides qualitative alterations, we hypothesized that IH could also modify body fat distribution, a key factor for metabolic complications. C57BL6 mice exposed to IH (21–5% FiO2, 60 s cycle, 8 h/day) or air for 6 weeks were investigated for topographic fat alterations (whole-body MRI). Specific role of epididymal fat in IH-induced metabolic dysfunctions was assessed in lipectomized or sham-operated mice exposed to IH or air. Whereas total white fat volume was unchanged, IH induced epididymal adipose tissue (AT) loss with non-significant increase in subcutaneous and mesenteric fat. This was associated with impaired insulin sensitivity and secretion. Epididymal lipectomy led to increased subcutaneous fat in the perineal compartment and prevented IH-induced metabolic disturbances. IH led to reduced epididymal AT and impaired glucose regulation. This suggests that, rather than epididymal AT volume, qualitative fat alterations (i.e. inflammation) could represent the main determinant of metabolic dysfunction. This deterioration of glucose regulation was prevented in epididymal-lipectomized mice, possibly through prevention of IH-induced epididymal AT alterations and compensatory increase in subcutaneous AT.

S1 guidelines: Lipedema.

The present, revised guidelines on lipedema were developed under the auspices of and funded by the German Society of Phlebology (DGP). The recommendations are based on a systematic literature search and the consensus of eight medical societies and working groups. The guidelines contain recommendations with respect to diagnosis and management of lipedema. The diagnosis is established on the basis of medical history and clinical findings. Characteristically, there is a localized, symmetrical increase in subcutaneous adipose tissue in arms and legs that is in marked disproportion to the trunk. Other findings include edema, easy bruising, and increased tenderness. Further diagnostic tests are usually reserved for special cases that require additional workup. Lipedema is a chronic, progressive disorder marked by the individual variability and unpredictability of its clinical course. Treatment consists of four therapeutic mainstays that should be combined as necessary and address current clinical symptoms: complex physical therapy (manual lymphatic drainage, compression therapy, exercise therapy, and skin care), liposuction and plastic surgery, diet, and physical activity, as well as psychotherapy if necessary. Surgical procedures are indicated if -despite thorough conservative treatment - symptoms persist, or if there is progression of clinical findings and/or symptoms. If present, morbid obesity should be therapeutically addressed prior to liposuction.

Changes in body composition and metabolic profile during interleukin 6 inhibition in rheumatoid arthritis.

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased mortality associated with cardiometabolic disorders including dyslipidaemia, insulin resistance, and cachectic obesity. Tumour necrosis factor inhibitors and interleukin 6 receptor blocker licensed for the treatment of RA decrease inflammation and could thus improve cardiovascular risk, but their effects on body composition and metabolic profile need to be clarified. We investigated the effects of tocilizumab (TCZ), a humanized anti‐interleukin 6 receptor antibody, on body composition and metabolic profile in patients treated for RA.MethodsTwenty‐one active RA patients treated with TCZ were included in a 1 year open follow‐up study. Waist circumference, body mass index, blood pressure, lipid profile, fasting glucose, insulin, serum levels of adipokines and pancreatic/gastrointestinal hormones, and body composition (dual‐energy X‐ray absorptiometry) were measured at baseline and 6 and 12 months of treatment. At baseline, RA patients were compared with 21 non‐RA controls matched for age, sex, body mass index, and metabolic syndrome.ResultsCompared with controls, body composition was altered in RA with a decrease in total and appendicular lean mass, whereas fat composition was not modified. Among RA patients, 28.6% had a skeletal muscle mass index below the cut‐off point for sarcopaenia (4.8% of controls). After 1 year of treatment with TCZ, there was a significant weight gain without changes for fat mass. In contrast, an increase in lean mass was observed with a significant gain in appendicular lean mass and skeletal muscle mass index between 6 and 12 months. Distribution of the fat was modified with a decrease in trunk/peripheral fat ratio and an increase in subcutaneous adipose tissue. No changes for waist circumference, blood pressure, fasting glucose, and atherogenic index were observed.ConclusionsDespite weight gain during treatment with TCZ, no increase in fat but a modification in fat distribution was observed. In contrast, muscle gain suggests that blocking IL‐6 might be efficient in treating sarcopaenia associated with RA.

Decreased beige adipocyte number and mitochondrial respiration coincide with increased histone methyl transferase (G9a) and reduced FGF21 gene expression in Sprague–Dawley rats fed prenatal low protein and postnatal high-fat diets

We have shown that prenatal low-protein (LP) followed by postnatal high-fat (HF) diets result in a rapid increase in subcutaneous adipose tissue (subc-AT) mass in the offspring, contributing to development of obesity and insulin resistance. Studies have shown that a key transcription factor, PR domain containing 16 (PRDM16), and fibroblast growth factor 21 (FGF21) are involved in conversion of precursor cells into mitochondria (mt)-enriched beige adipocytes (BA). Our hypothesis is that a maternal LP and postnatal HF diets increase the risk of obesity and insulin resistance in offspring, in part, by reducing the conversion of precursor cell into BA in the subc-AT of offspring. Using obese-prone Sprague–Dawley rats fed 8% LP or 20% normal-protein (NP) diets for 3 weeks prior to conception and throughout pregnancy and lactation followed by 12 weeks of 10% normal-fat (NF) or 45% HF diet feeding, we investigated whether prenatal LP and postnatal HF diets affect BA number and oxidative respiratory function in subc-AT. Results showed that subc-AT and liver FGF21, PRDM16 and BA marker CD137 mRNA increase with postnatal HF diet in maternal NP group rats. In contrast, rats fed maternal LP and postnatal HF diets showed no increase in subc-AT mt copy number, oxygen consumption rate, FGF21, PRDM16 and CD137 mRNA, whereas protein expression of an inhibitor for FGF21 transcription (histone methyltransferase, G9a) increased. These findings suggest that LPHF diets cause offspring metabolic alterations by reduced BA and FGF21 mRNA and increased G9a protein expression in subc-AT.

Effects of insulin therapy on weight gain and fat distribution in the HF/HS-STZ rat model of type 2 diabetes.

Insulin therapy is required for many patients with the obesity-related disorder type 2 diabetes, but is also associated with weight gain. The specific location of adipose tissue location matters to cardiovascular disease (CVD) risk. We investigated effects of exogenous insulin on fat distribution in the high-fat/high-sucrose fed rat treated with streptozotocin (HF/HS-STZ) rat model of type 2 diabetes. We also examined effects of insulin therapy on circulating CVD markers, including adiponectin, triglycerides (TGs), total cholesterol and high-density lipoprotein. Male SD rats were HF/HS fed for 5 weeks followed by STZ treatment to mimic the hallmarks of human obesity-associated insulin resistance followed by hyperglycemia. Magnetic resonance imaging and computed tomography were used to determine total fat, abdominal fat distribution and liver fat before and after insulin therapy in HF/HS-STZ rats. HbA1c%, TGs, cholesterol, high-density lipoprotein and adiponectin were analyzed by conventional methods adapted for rats. Insulin therapy lowered HbA1c (P<0.001), increased body weight (P<0.001), increased lean mass (P<0.001) and led to a near doubling of total fat mass (P<0.001), with the highest increase in subcutaneous adipose tissue as compared with visceral adipose tissue (P<0.001). No changes in liver fat were observed after insulin therapy, whereas plasma TG and cholesterol levels were decreased (P<0.001, P<0.01), while high-density lipoprotein (HDL) and adiponectin levels were elevated (P<0.01, P<0.001). Using the HF/HS-STZ rat as an animal model for type 2 diabetes, we find that insulin therapy modulates fat distribution. Specifically, our data show that insulin has a relatively positive effect on CVD-associated parameters, including abdominal fat distribution, lean body mass, adiponectin, TGs and HDL in HF/HS-STZ rats, despite a modest gain in weight.

Microstructural inhomogeneity of electrical conductivity in subcutaneous fat tissue.

Microscopic peculiarities stemming from a temperature increase in subcutaneous adipose tissue (sWAT) after applying a radio-frequency (RF) current, must be strongly dependent on the type of sWAT. This effect is connected with different electrical conductivities of pathways inside (triglycerides in adipocytes) and outside (extra-cellular matrix) the cells and to the different weighting of these pathways in hypertrophic and hyperplastic types of sWAT. The application of the RF current to hypertrophic sWAT, which normally has a strongly developed extracellular matrix with high concentrations of hyaluronan and collagen in a peri-cellular space of adipocytes, can produce, micro-structurally, a highly inhomogeneous temperature distribution, characterized by strong temperature gradients between the peri-cellular sheath of the extra-cellular matrix around the hypertrophic adipocytes and their volumes. In addition to normal temperature effects, which are generally considered in body contouring, these temperature gradients can produce thermo-mechanical stresses on the cells’ surfaces. Whereas these stresses are relatively small under normal conditions and cannot cause any direct fracturing or damage of the cell structure, these stresses can, under some supportive conditions, be theoretically increased by several orders of magnitude, causing the thermo-mechanical cell damage. This effect cannot be realized in sWAT of normal or hyperplastic types where the peri-cellular structures are under-developed. It is concluded that the results of RF application in body contouring procedures must be strongly dependent on the morphological structure of sWAT.

Linking maternal obesity to early insulin resistance.

Linking maternal obesity to early insulin resistance.

Increase in subcutaneous adipose tissue and fat free mass in women with polycystic ovary syndrome is related to impaired insulin sensitivity

Objectives: The present study was performed to search whether subcutaneous and whole body adipose tissue increase and they relate to measures of insulin sensitivity in women with polycystic ovary syndrome (PCOS).Materials and methods: 52 women with PCOS and 53 healthy controls, all with similar age and body mass index participated in the study. A skinfold caliper device was used to measure biceps, triceps, subscapular and suprailiac skinfold thickness (SFT). Mid-upper arm circumference (MUAC) was measured using a tape measure. Body fat distributions were determined by bioelectrical impedance analysis. Insulin resistance score was computed with the HOMA formula. Plasma adiponectin was measured by EIA.Results: SFT in all defined areas, MUAC, total body and trunk fat free mass, and HOMA score were higher in women with PCOS compared with healthy women, while adiponectin level was significantly lower. SFT values correlated positively with HOMA score, and negatively with blood adiponectin level. Regression analysis indicated, SFT in triceps and supscapular areas, trunk fat mass, trunk fat ratio, fat free mass and trunk fat free mass values as the most powerful predictors of HOMA score.Conclusions: The present study showed that SFT in different body regions and fat-free tissue mass are increased in women with PCOS, with a significant relation to impaired insulin sensitivity.

Abstract 002: Race and Sex Influence the Associations of Subcutaneous and Visceral Adipose Tissues with Calcified Plaque of the Coronary and Abdominal Aortic Arteries: The Family Heart Study

Previous research suggests that visceral adipose tissue (VAT) increases risk for atherosclerosis and specifically arterial calcification, yet the association of subcutaneous adipose tissue (SAT) with calcification is less substantiated. Studies have also noted important race and sex differences in risk of atherosclerosis. In the Family Heart Study, we examined race and sex differences in the pattern of associations of abdominal fat depots with coronary (CAC) and abdominal aorto-iliac (AAC) calcified plaque measured using computed tomography (CT). Methods- We used CT to measure abdominal fat volume and arterial calcified plaque in 2,748 participants of European American descent (EA; n=1512 females) and 626 participants of African American descent (AA; n=412 females) in the Family Heart Study. CAC and AAC were defined as present (≥1) or absent (0) based on Agatston scores. Odds ratios (OR) and 95% confidence intervals (95% CI) were determined using logistic regression models adjusted for age, field center, family pedigree, race, and history of coronary heart disease (CHD), diabetes, hypertension, hypercholesterolemia, and smoking. Results- The association of SAT and VAT with prevalent CAC and AAC varied with sex and race in multivariable logistic regression models. In males, SAT was strongly associated with both CAC (p=0.001) and AAC (p&lt;0.001) in multivariable models and there was evidence that the associations of SAT with CAC and AAC differed by race (each p interaction SAT*race p&lt;0.01). The associations of SAT with CAC and AAC appeared to be stronger in EA males than in AA males. In EA, the OR for CAC for a single SD increase in SAT was 2.17 (95% CI 1.37-3.45) whereas for AA the OR was 1.42 (95% CI 1.17-1.72) per SD increase in SAT. Also, in EA males the OR for AAC per SD increase in SAT was 2.69 (95% CI 1.61-4.50) compared to 1.39 (95% CI 1.11-1.73) in AA males. VAT was significantly associated with prevalent CAC in both EA males (OR=1.96 per SD increase, p=0.02) and AA males (OR=1.26 per SD increase, p=0.02) though there were no significant associations of VAT with AAC among males. In females, both SAT (OR=1.18 per SD increase, p=0.004) and VAT (OR=1.21 per SD increase, p=0.003) were associated with prevalent CAC, but not AAC, in multivariable models and associations did not vary by race. Conclusions- Abdominal SAT was associated with both CAC and AAC prevalence in males, and associations appeared to be stronger in EA compared to AA participants. VAT was predictive of CAC in both EA and AA males. In contrast, SAT and VAT were only associated with CAC in females and no differences by race were noted. Our findings suggest that SAT, and by inference obesity, along with VAT may be an important contributors to prevalence of arterial calcification and that race plays a role in associations among males.

Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss

Increased thyroid-stimulating hormone (TSH) and FT(3) levels are often found in clinically euthyroid obese individuals. Information on thyroid gene expression in human adipose tissue is scarce. The objective of this study was to measure the expression of the TSH receptor (TSHR) and the thyroid hormone receptor (TRalpha1) genes in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese individuals and to test the effect of weight loss on these genes. This study is a prospective study involving 107 obese (body mass index (BMI)=46+/-8 kg m(-2), 52 with type 2 diabetes or impaired glucose tolerance) and 12 lean nondiabetic participants. A total of 27 obese patients were restudied 1 year after gastric bypass surgery. Total RNA was extracted from SAT and VAT obtained at baseline from all participants, and from SAT in obese patients post surgery. Circulating TSH and FT(3) levels were 170 and 36%, respectively, higher in obese patients than in controls. In SAT, TSHR and TRalpha1 were reduced in the obese by 67 and 33%, respectively, regardless of glucose tolerance. A similar trend was found in VAT. Post surgery, a BMI decrease of 33% was associated with a decrease in TSH and FT(3) levels and with a 150 and 70% increase in SAT of TSHR and TRalpha1, respectively. In both subcutaneous and visceral fat, the thyroid gene expression (especially TSHR) is reduced in obesity. The reversal of these changes with major weight loss and the reciprocal changes in plasma TSH and FT(3) levels suggest a role for adipocytes in the regulation of TSH and thyroid hormones.

Máxima Fase estável de lactato em ratos obesos de ambos os gêneros

A incidência de obesidade vem crescendo entre a população mundial, levando a inúmeras complicaçõe,s como risco de doenças crônico-degenerativas. Por outro lado, o exercício físico tem sido empregado isoladamente ou em associação a dieta, no tratamento dessa doença. Assim, pesquisas envolvendo exercício são imprescindíveis para evolução no tratamento e controle da obesidade. O objetivo deste estudo foi identificar a intensidade de exercício equivalente à transição metabólica aeróbio-anaeróbia em ratos Wistar obesos de ambos os gêneros, por tratamento com glutamato monossódico (MSG), utilizando o protocolo de máxima fase estável de lactato (MFEL). Para isso, foram testados 40 ratos adultos subdivididos em quatro grupos com 10 animais cada um: controle machos, controle fêmeas, obeso machos e obeso fêmeas. Depois de adequada adaptação (três semanas) ao exercício em meio líquido (31 ± 1ºC) os animais foram submetidos a teste de natação (25 min) suportando sobrecargas contínua e aleatória correspondentes a 4,5 - 5,0 - 5,5 - 6,0 e 6,5% do peso corporal (PC), com intervalo de 72 horas entre elas. Os animais dos grupos obesos tiveram aumentos no peso do tecido adiposo subcutâneo, mesentérico e retroperitonial em relação aos grupos controle. O índice de Lee foi maior nos animais obesos em comparação com os controles. Foi possível identificar a MFEL a 6,0% do PC nos dois grupos obesos. Para o grupo controle fêmea, a MFEL esteve por volta de 5,0% do PC enquanto que nos controle macho a 4,5% do PC. Desse modo pode-se concluir que a obesidade induzida por MSG interfere na cinética de lactato durante o exercício em ambos os sexos, alterando a intensidade de esforço referente à transição metabólica.

WEIGHT GAIN AND FAT DISTRIBUTION WITH PIOGLITAZONE IN PATIENTS WITH TYPE 2 DIABETES ON INSULIN THERAPY.

Background Thiazolidinediones (TZDs) are widely used to treat type 2 diabetes (T 2 DM). As PPAR-γ agonists, TZDs improve insulin sensitivity and glycemic control and have other beneficial nonglycemic effects. However, weight gain is an undesirable side effect and is of potential concern. Recent studies demonstrate that weight gain with TZD therapy is associated with an increase in subcutaneous adipose tissue (SAT) and a concomitant decrease in visceral adipose tissue (VAT). Insulin therapy alone is also associated with weight gain; however, body fat composition has not been studied with insulin therapy or with the additive effects of insulin and TZD therapy. Objective To evaluate the effects of a pioglitazone and insulin combination versus insulin therapy alone on body fat distribution. Methods We performed a randomized, double-blind placebo-controlled trial on 25 insulin-treated, obese T 2 DM patients (BMI 36.5 kg/m 2 , HbA 1C 7.7%). Twelve patients were assigned pioglitazone (30 mg titrated to 45 mg) and insulin (PIO + INS) and 13 patients were assigned placebo and insulin (PLA + INS). Abdominal CT scans were performed before and after 12 to 16 weeks of treatment. VAT and SAT pre- and post-treatment and liver/spleen attenuation (L/S) ratios were measured (an L/S ratio Results In the PLA-INS group, body weight increased from 108.7 to 110.1 kg ( p = .02), HbA 1C decreased from 7.8 to 7.2% ( p = .02), SAT increased from 412.9 to 420.8 cm 2 ( p = .31), and VAT decreased from 266.6 to 250.5 cm 2 ( p = .17). In the PIO + INS group, weight increased from 107.1 to 112.0 kg ( p = .00), HbA 1C decreased from 7.6 to 7.1% ( p = .03), SAT increased from 393.9 to 443.2 cm 2 ( p = .001), and VAT decreased from 240.3 to 223.8 cm 2 ( p = .13). When the two groups were compared, a significant increase in the SAT ( p = .01) and a trend toward decreased VAT was noted in the PIO + INS group compared with the PLA + INS group. Further, the L/S ratio in the PLA + INS group decreased from 1.08 to 1.04 ( p = NS) and increased from 0.999 to 1.075 ( p = .06) in the PIO + INS group, suggesting that pioglitazone combined with insulin decreases liver fat compared with insulin alone. Conclusions In patients treated with insulin, at equivalent glycemia, the addition of pioglitazone is associated with increased SAT, decreased VAT, and decreased liver fat. These changes in body fat distribution could possibly contribute to the beneficial effects of the TZDs despite overall weight gain.